In chronic sinusitis lasting more than eight weeks, what is the best imaging study to evaluate for complications or underlying disease?

• A. Culture
• B. XRAY
• C. Admits + IV ABX
• D. CT scan

Answer: (D)

Chronic sinusitis that lasts many weeks requires an imaging test that clearly shows the sinus anatomy and how far the disease has spread. A CT scan of the sinuses provides detailed images of the bone structures, sinus walls, and the extent of sinus opacification or mucosal thickening, along with any obstruction of the ostia. It also reveals complications such as orbital involvement or intracranial extension and helps guide surgical planning if needed. Plain radiographs lack sensitivity and miss many areas, and don’t show soft tissue or bone detail well. Cultures identify organisms but don’t map disease extent, and admitting someone with IV antibiotics is a management step, not an imaging choice. So a sinus CT is the best imaging study to evaluate for complications or underlying disease in chronic sinusitis.